2014.03.12 【英译中】I型糖尿病

一只筱蝶 (一只筱蝶) 路人甲
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发表于:2014-03-12 21:40 [只看楼主] [划词开启]

Type 1 Diabetes (b-Cell Destruction,Usually Leading to Absolute Insulin Deficiency)

1型糖尿病(β细胞破坏,常导致胰岛素绝对缺乏)

Immune-Mediated Diabetes

免疫介导的糖尿病

This form of diabetes, which accounts for only 5–10% of those with diabetes, previously encompassed by the terms insulin-dependent diabetes or juvenileonset diabetes, results from a cellularmediated autoimmune destruction of theb-cells of the pancreas. Markers of the immune destruction of theb-cell include islet cell autoantibodies, autoantibodies to insulin, autoantibodies to GAD (GAD65), and autoantibodies to
thetyrosinephosphatasesIA-2and IA-2b. One and usually more of these autoantibodies are present in 85–90% of individuals when fasting hyperglycemia is initially detected. Also, the disease has strong HLA associations, with linkage to the DQA and DQB genes, and it is

influenced by the DRB genes. These HLA-DR/DQ alleles can be either predisposing or protective.

这种类型的糖尿病,仅占糖尿病的5%-10%。以前还包括胰岛素依赖型糖尿病或青少年发病型糖尿病,是来自胰腺的β-细胞介导的自身免疫破坏的结果。β-细胞免疫杀伤性标志物包括胰岛细胞自身抗体,胰岛素自身抗体,谷氨酸脱羧酶(GAD65)抗体,酪氨酸磷酸酶抗体,胰岛抗原2(IA-2)和胰岛抗原2b(IA-2b)。85–90%的首次空腹血糖检测高的人,血清中存在一个或多个的抗体。此外,该病与HLA区域密切相关,与DQA和DQB基因连锁,受DRB基因影响。这些HLA-DR / DQ等位基因可以诱发疾病或保护作用。

 In this form of diabetes, the rate of b-cell destruction is quite variable, being rapid in some individuals (mainly infants and children) and slow in others (mainly adults). Some patients, particularly children and adolescents, may present with ketoacidosis as the first manifestation of the disease. Others have modest fasting hyperglycemia that can rapidly change to severe hyperglycemia and/or ketoacidosis in the presence of infection or other stress. Still others, particularly adults, may retain residualb-cell function sufficient to prevent ketoacidosis for many years; such individuals eventually become dependent on insulin for survival and are at risk for ketoacidosis. At this latter stage of the disease, there is little or no insulin secretion, as manifested by low or undetectable levels of plasma C-peptide. Immune-mediated diabetes

commonly occurs in childhood and adolescence, but it can occur at any age, even in the 8th and 9th decades of life.

 该类型的糖尿病,β-细胞破坏率是不同的,在某些个体破坏量大(主要是婴儿和儿童),在另外一些个体破坏很小(主要为成人)。有些患者,尤其是儿童和青少年,酮症酸中毒表现为疾病的首发症状。一些患者空腹高血糖水平适中,当合并感染和其他应激情况时,可以迅速发展为严重的高血糖和/或酮症酸中毒。还有一些人,尤其是成年人,残余B细胞功能足以防止酮症酸中毒,这样的人最终依赖胰岛素生存并且存在酮症酸中毒危险。在该阶段的疾病,胰岛素很少甚至是不分泌,表现为低或检测不到血浆C肽水平。免疫介导的糖尿病通常发生在童年和青春期,但它可以发生在任何年龄,甚至在80或90岁。

Autoimmune destruction of b-cells has multiple genetic predispositions and is also related to environmental factors that are still poorly defined. Although patients are rarely obese when they present with this type of diabetes, the presence of obesity is not incompatible with the diagnosis. These patients are also prone to other autoimmune disorders such as Graves’ disease, Hashimoto’s thyroiditis, Addison’sdisease, vitiligo, celiac sprue,autoimmune hepatitis, myasthenia gravis, and pernicious anemia. 

 自身免疫性介导的β-细胞的破坏具有多基因遗传因素,和环境因素也有一定关系,目前尚无法明确环境因素。这类患者很少肥胖,但肥胖并不排除本病的可能。这类患者也容易合并其他自身免疫型疾病,如Graves'病, 桥本氏甲状腺炎,阿狄森氏病,白癜风,乳糜泻,

自身免疫性肝炎,重症肌无力及恶性贫血。

Idiopathic Diabetes 

特发性糖尿病

Some forms of type 1 diabetes have no known etiologies. Some of these patients have permanent insulinopenia and are prone to ketoacidosis, but have no evidence of autoimmunity. Although only a minority of patients with type 1 diabetes fall into this category, of thosewho do, most are of African or Asianancestry. Individuals with this form of diabetes suffer from episodic ketoacidosis and exhibit varying degrees of insulin

deficiency between episodes. This form of diabetes is strongly inherited, lacks immunological evidence for b-cell autoimmunity, and is not HLA associated. An absolute requirement for insulin replacement therapy in affected patients may come and go(这句不知道怎么翻译,求指点).

一些1型糖尿病没有自身免疫证据。一些人有永久胰岛素缺乏,易患酮症酸中毒,但没有自身免疫证据。尽管只有少数的1型糖尿病患者属于这个类型,这些患者大多数是非洲或亚洲血统。该类型的糖尿病患者表现为发作性酮症酸中毒和不同程度的胰岛素缺乏。这种类型的糖尿病具有遗传性,缺乏β-细胞介导的自身免疫证据,与HLA无相关。感染患者需要胰岛素绝对替代治疗。


分类: 英语

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